High first-trimester neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are indicators for early diagnosis of preeclampsia

Objectives: The aim of our study is to determine whether first-trimester neutrophil-to-lymphocyte ratio (NLR) and plate­let-to-lymphocyte ratio (PLR) would be useful as new predictors of subsequent preeclampsia. Material and methods: Medical records of women with preeclampsia and healthy controls from a tertiary referral center were retrospectively evaluated. The two groups were compared in terms of clinical characteristics and first-trimester levels of hemoglobin, leukocyte, neutrophil, lymphocyte, platelet, NLR and PLR. Receiver operating characteristic curve (ROC) analysis was performed to identify the optimal NLR and PLR levels predicting preeclampsia. Results: Neutrophil (p < 0.001), platelet (p < 0.001), NLR (p < 0.001) and PLR (p < 0.001) levels were significantly elevated, whereas hemoglobin concentration (p = 0.003) was significantly lower in the group with preeclampsia as compared to the control group. On multivariate regression analysis, NLR (OR 1.43; 95% CI 1.21–1.76; p = 0.005) and PLR (OR 1.38; 95% CI 1.15–1.63; p = 0.008) were the most powerful predictive variables. The area under the ROC was 0.716 and 0.705 for NLR and PLR, respectively. The cut-off values of NLR ≥ 3.08 and PLR ≥ 126.8 predicted preeclampsia with the sensitivity of 74.6% and 71.8% and specificity of 70.1% and 72.4%, respectively. Conclusions: High NLR and PLR during the first trimester are independent predictors of subsequent preeclampsia

Unusual cause of acute abdominal pain in a postmenopausal woman: adnexal torsion

Adnexal torsion is an infrequent but significant cause of acute lower abdominal pain in women. While adnexal torsion is generally considered in premenopausal women presenting with acute abdominal pain and a pelvic mass, it is a rare cause of acute abdominal pain during postmenopausal period. The diagnosis of adnexal torsion is often challenging due to nonspesific clinical, laboratory and physical examination findings. Causes of adnexal torsion is also different in premenopausal and postmenopausal women. While a simple functional cyst is often the cause of torsion in premenopausal women, it is more rarely the cause in postmenopausal women. Adnexal torsion is a surgical emergency. The surgery of adnexal torsion is performed either via conventional exploratory laparotomy or laparoscopic surgery. Adnexal torsion in postmenopausal women should be considered not only in the setting of sudden onset pain, but also in long-term abdominal discomfort. In this article, we presented a case with adnexal torsion that rarely cause acute abdominal pain in postmenopausal women

Quantitative Evaluation of the Fetal Cerebellar Vermis Using the Median View on Two-Dimensional Ultrasound

Background: Evaluation of the cerebellum and vermis is one of the integral parts of the fetal cranial anomaly screening

The value of red cell distribution width for predicting subsequent preeclampsia

Purpose: The purpose of our study was too assess the diagnostic value of red cell distribution width and other inflammatory markers such as white blood cell count and mean platelet volume during the first trimester of gestation for predicting the subsequent development of preeclampsia. Material and Methods: A retrospective study was performed on 137 patients with preeclampsia and 150 normotensive pregnant women. Study group was assessed for presence of preeclampsia and the values of first trimester red cell distribution width, white blood cell count and mean platelet volume. The receiver operator curve was used to evaluate cut-off, sensitivity and specificity values. Results: The optimal cut-off points to predict preeclampsia were a white blood cell count 10200 cells/mm3 or higher with a sensitivity of 75.1% and specificity of 44.1%, a mean platelet volume 8.6fL or lower with a sensitivity of 62.5% and specificity of 64.4% and a red cell distribution width 15.3% or lower with a sensitivity of 31.2% and specificity of 79.7%. Conclusion: Regarding the association between first trimester red cell distribution width, white blood cell count and mean platelet volume, statistical analysis revealed that these markers were weak predictors of preeclampsia [Cukurova Med J 2016; 41(2.000): 224-228

Prognostic Value of Fetal Thymus Size in Intrauterine Growth Restriction

Objectives-Our aim was to evaluate the size of the fetal thymus by sonography in pregnancies with intrauterine growth restriction (IUGR) and to search for a possible relationship between a small fetal thymus and adverse perinatal outcomes

Identification of preterm birth in women with threatened preterm labour between 34 and 37 weeks of gestation

The aim of this study was to assess whether serum markers would be useful as a new predictor of preterm birth in patients with spontaneous, late preterm labour. Patients diagnosed with late preterm labour were divided into preterm delivery (229 patients) and term delivery (178 patients) groups. The two groups were compared in terms of clinical characteristics and levels of serum markers (leukocyte subtypes, platelet, C-reactive protein [CRP], neutrophil to lymphocyte ratio [NLR] and platelet to lymphocyte ratio [PLR]), which were obtained at admission. The levels of leukocyte (p 6.2 had the highest sensitivity (65.1%) and specificity (62.5%). High NLR at admission is an independent predictor of preterm birth in patients with spontaneous, late preterm labour.Impact statement What is already known on this subject: Preterm birth accounts for 5–12% of all births, and is a major factor associated with perinatal morbidity and mortality worldwide. However, more than 70% of preterm births occur at late preterm between 340/7 and 366/7 weeks of gestation. The central role of systemic and subclinical infections in preterm labour is well documented. Intrauterine infection leading to delivery can be measured by using a variety of laboratory parameters. What do the results of this study add: Neutrophil to lymphocyte ratio is an inexpensive, easily interpretable and promising haematologic parameter that is widely available. This study explored the association of high neutrophil to lymphocyte ratio with the risk of preterm birth in women with preterm labour between 34 and 37 weeks of gestation. What are the implications of these findings for clinical practice and/or further research: Neutrophil to lymphocyte ratio could be used in combination with existing markers to improve detection rates of preterm birth. Concomitant use of markers could be more powerful than measuring any of the individual markers alone

The role of maternal free testosteron and dehydroepiandrosterone sulfate in preeclampsia

Purpose: The purpose of our study was to investigate whether maternal serum levels of androgens, especially testosterone, are higher in patients with preeclampsia than in matched normotensive control subjects. Material and Methods: A prospective study was performed on 67 preeclamptic patients and 51 normotensive pregnant women. Study group was assessed for presence of preeclampsia and the values of serum free testosterone and dehydroepiandrosterone sulfate. The receiver operator curve was used to evaluate cut-off, sensitivity and specificity values. Results: Free testosterone levels were significantly higher in patients with preeclampsia (2.36+/-1.2 pg/ml) than the control group (1.62+/-0.96 pg/ml) but there was no significant difference in dehydroepiandrosterone sulfate levels. The optimal cut-off point to predict preeclampsia was a 2.025 pg/ml or higher levels for free testosteron with a sensitivity of 56%, specificity of 78.4%, positive predictive value of 71.8%, negative predictive value of 64.5% and with a likelihood ratio of 2.6. Discussion: Levels of the potent androgen free testosterone were significantly higher in women with preeclampsia than in normotensive women with similar maternal ages. Although the statistical analysis revealed that these markers were weak predictors of preeclampsia to be used in clinical practice the difference may indicate a role for testosterone in the pathogenesis of preeclampsia. [Cukurova Med J 2016; 41(1.000): 41-46

The role of maternal free testosteron and dehydroepiandrosterone sulfate in preeclampsia

Purpose: The purpose of our study was to investigate whether maternal serum levels of androgens, especially testosterone, are higher in patients with preeclampsia than in matched normotensive control subjects. Material and Methods: A prospective study was performed on 67 preeclamptic patients and 51 normotensive pregnant women. Study group was assessed for presence of preeclampsia and the values of serum free testosterone and dehydroepiandrosterone sulfate. The receiver operator curve was used to evaluate cut-off, sensitivity and specificity values. Results: Free testosterone levels were significantly higher in patients with preeclampsia (2.36+/-1.2 pg/ml) than the control group (1.62+/-0.96 pg/ml) but there was no significant difference in dehydroepiandrosterone sulfate levels. The optimal cut-off point to predict preeclampsia was a 2.025 pg/ml or higher levels for free testosteron with a sensitivity of 56%, specificity of 78.4%, positive predictive value of 71.8%, negative predictive value of 64.5% and with a likelihood ratio of 2.6. Discussion: Levels of the potent androgen free testosterone were significantly higher in women with preeclampsia than in normotensive women with similar maternal ages. Although the statistical analysis revealed that these markers were weak predictors of preeclampsia to be used in clinical practice the difference may indicate a role for testosterone in the pathogenesis of preeclampsia. [Cukurova Med J 2016; 41(1.000): 41-46

Benefits of short-term structured exercise in non-overweight women with polycystic ovary syndrome: a prospective randomized controlled study

[Purpose] The short-term effects of structured exercise on the anthropometric, cardiovascular, and metabolic parameters of non-overweight women diagnosed with polycystic ovary syndrome were evaluated. [Subjects and Methods] Thirty women with a diagnosis of polycystic ovary syndrome were prospectively randomized to either a control group (n=16) or a training group (n=14) for a period of 8 weeks. Anthropometric, cardiovascular, and metabolic parameters and hormone levels were measured and compared before and after the intervention. [Results] Waist and hip measurements (anthropometric parameters); diastolic blood pressure; respiratory rate (cardiovascular parameters); levels of low-density lipoprotein cholesterol, total cholesterol, fasting glucose, and fasting insulin; and the homeostasis model assessment of insulin resistance index (metabolic parameters) were significantly lower in the training group after 8 weeks of exercise compared to the baseline values. After exercise, the training group had significantly higher oxygen consumption and high-density lipoprotein levels and significantly shorter menstrual cycle intervals. The corresponding values for controls did not significantly differ between the start and end of the 8-week experiment. [Conclusion] Short-term regular exercise programs can lead to improvements in anthropometric, cardiovascular, and metabolic parameters of non-overweight women with polycystic ovary syndrome